type one

Question 1

for a new patient assume 1-2 units of insulin will decrease FBG by

Answer 1

40-50 mg/dL

Question 2

adjust one doe at a time unless

Answer 2

all glucose levels are greater than 200

Question 3

initial dose of insulin

Answer 3

0.4-0.6 units/kg/day

Question 4

honeymoon phase dose of insulin

Answer 4

0.1-0.4 units/kg/day

Question 5

ketosis/infection insulin dose

Answer 5

1.0-1.5 units/kg/day

Question 6

type two daily dose of insulin

Answer 6

0.7-1.5 units/kg/day

Question 7

honeymoon phase

Answer 7

time period shortly after initiating insulin therapy when totally daily dose decreases

Question 8

onset of honeymoon phase

Answer 8

within days to weeks after initial diagnosis

Question 9

how long can the honeymoon phase last?

Answer 9

up to a year

Question 10

TDD

Answer 10

insulin in a 24 hour period; half should be basal and the other half bolus

Question 11

meal bolus

Answer 11

500 rule (500 divided by TDD

Question 12

insulin sensitivity factor determines

Answer 12

how the patient responds to 1 unit of insulin

Question 13

1800 rule

Answer 13

1800/TDD = how much one unit will lower BG

Question 14

pattern management

Answer 14

1. review several days of home BG readings
2. do not react to single high or low
3. nutrition education
4. review all variables

Question 15

simplest regimen for type one

Answer 15

2 injections a day (breakfast and supper)

Question 16

2/3rd of total dose injected prior to

Answer 16

breakfast

Question 17

1/3rd dose prior to

Answer 17

supper

Question 18

first injection may be split

Answer 18

2/3rds NPH with 1/3rd regular or rapid insulin

Question 19

can the second injection be split?

Answer 19

yes

Question 20

which goes first, clear or cloudy?

Answer 20

clear before cloudy

Question 21

regimen of two injections a day allows for

Answer 21

adjustment based on home BG readings

Question 22

dawn phenomenon

Answer 22

rise in blood glucose levels between 4 and 8 am

Question 23

is dawn phenomenon caused by counter regulatory hormones secondary to hypoglycemia

Answer 23

no

Question 24

does dawn phenomenon happen in type one or type two

Answer 24

both

Question 25

dawn phenomenon means there is not enough insulin..

Answer 25

in the evening

Question 26

four injections a day

Answer 26

calculate TDD and divided 50/50 for basal and bolus

Question 27

best regimen without a pump

Answer 27

basal insulin with the patient CHO counting and correcting

Question 28

toujeo and Tresiba stability at room temp

Answer 28

56 days

Question 29

Novolog stability at room temp

Answer 29

14 days

Question 30

Humalog stability at room temp

Answer 30

10 days

Question 31

side effects of insulin

Answer 31

weight gain, nodules, lipohypertrophy, lipatrophy

Question 32

preferred site of injection

Answer 32

abdomen - most consistent rate of absorption

Question 33

where has the slowest rate of absorption

Answer 33

buttocks and thighs

Question 34

3/10 cc for doses

Answer 34

30 units or less

Question 35

1/2 cc for doses

Answer 35

31-50 units

Question 36

1 cc for doses

Answer 36

51 to 100 units

Question 37

typical length of needles

Answer 37

6 mm or short 8 mm

Question 38

typical gauge used

Answer 38

31 gauge

Question 39

nano pen needles

Answer 39

4mm, 32 gauge

Question 40

mini pen needles

Answer 40

5mm, 31 gauge

Question 41

6mm needles

Answer 41

6mm, 30 gauge

Question 42

short pen needles

Answer 42

8mm, 31 gauge

Question 43

monitoring therapy

Answer 43

home blood glucose readings, post prandial levels, A1C, hypoglycemic events, adherence

Question 44

LADA

Answer 44

slow onset T1DM or type 1.5

Question 45

LADA usually happens to those over age

Answer 45

30

Question 46

LADA is initially diagnosed as

Answer 46

type 2 DM

Question 47

treatment for LADA

Answer 47

may respond to oral agents, but will need insulin

Question 48

pramlintide

Answer 48

synthetic analog of amylin, deficient in diabetes

Question 49

MOA of pramlintide

Answer 49

inhibits postprandial glucagon secretion, slows gastric emptying, promotes satiety and reduces caloric intake

Question 50

when is pramlintide dosed

Answer 50

before meals, so reduce mealtime insulin by half initially

Question 51

increase dose of pramlintide if

Answer 51

no significate nausea for 3-7 days

Question 52

pramlintide type 1 dosing

Answer 52

15 mcg with a maintenance dose of 60mcg

Question 53

pramlintide type 2 dosing

Answer 53

60 mcg with a maintenance dose of 120 mcg

Question 54

contraindications of pramlintide

Answer 54

diagnosis of gastroparesis or hypoglycemia unawareness